X850 Corpus. Price list: 27 Spain EUR. Dealer Information. Client Information. Client Measurements

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1 list: 27 Spain EUR Dealer Information Contact: Customer Code: Customer Name: Address 1: City: Post code: Phone: Fax: PO: Client Information First Name: Last Name: Diagnosis: Address 1: Address 2: Postal code: City: Country: Phone: Client Measurements Weight: Height: 1) Upper leg length: 2) Chest Depth: 3) Seat pan to elbow: 4) Arm pit height: 5) Top of shoulders: 6) Top of head: 7) Elbow to Hand: 8) Chest width: 9) Knee to Foot: 10) Hip width: kg All specifications and prices are subject to change without notice. Please note that displayed prices are only valid if ordered with the wheelchair. Any parts ordered for service or future alterations will carry different prices and warranty. Rabobank Parkstad Limburg Rekening: IBAN: NL84RABO BIC/SWIFT: RABONL2U Permobil Europe B.V. De Doom 22 NL 6419 CX HEERLEN Phone: +31 (0) Fax: +31 (0) Page 1 of 7

2 Chassis Model X850 CORPUS EUR 13, User manual USER MANUAL EU X850 / CORPUS EUR - Drive unit DRIVE UNIT 15/KMH EUR - Charger connector CHARGER CONNECTOR XLR COMMON EUR - Colour covers COVERS X850 DARK BLUE METALLIC EUR COVERS X850 DARK GREY METALLIC EUR COVERS X850 RED METALLIC EUR - Extender POWERED WHEELBASE EXTENSION ( MM) EUR FIXED WHEELBASE EXTENSION ( MM) EUR - Wheels WHEELS (4 PCS) X850 DEEP PROFILE EUR WHEELS (4 PCS) X850 FINE PROFILE EUR - Accessories chassis Batteries BATTERIES, 97Ah, SET OF 2 EUR - Charger CHARGER JK MEDICO CCC410 EUR - Running time meter (+) RUNNING TIME METER C400/C500 EUR Rear mirror Right (+) REAR VIEW MIRROR RIGHT EUR Rear mirror Left (+) REAR VIEW MIRROR LEFT EUR Luggage carrier (+) LUGGAGE BOX FACING BACK- WARDS EUR LUGGAGE BOX FACING FOR- WARD EUR LUGGAGE CARRIER EUR Crutch holder Right (+) CRUTCH HOLDER RIGHT EUR Crutch holder Left (+) CRUTCH HOLDER LEFT EUR Rain cover (+) TARPAULIN/RAINCOVER FOR ALL MODLES EUR TARPAULIN FOR TRAX WITH ROLLBAR EUR Remote stop (+) REMOTE STOP VR2/SAFEGATE EUR User manual Remote stop (+) USER MANUAL ES REMOTE STOP EUR - Footplate Options (+) FOOTPLATE ADJUSTABLE TRAX EUR Seat assembly Seat lift system POWERED SEAT LIFT X850 EUR 1, SEAT HEIGHT FIXED X850 EUR - Seat assembly FIXED MOUNTING / NO SEAT SWIVEL X850 EUR POWERED SWIVEL SEAT 2x90 EUR 1, Page 2 of 7

3 Seat assembly MANUAL SWIVEL SEAT 2x90 EUR POWERED ADJ.SEAT TILT 14 X850 EUR 1, Cabling (+) ACTUATOR CONTROL WIRING KIT TRAX EUR - Seat Seat SEAT 430x360 WITHOUT CUSHION (BACKR ) EUR SEAT 430x410 WITHOUT CUSHION (BACKR ) EUR SEAT 430x460 WITHOUT CUSHION (BACKR ) EUR SEAT 430x510 WITHOUT CUSHION (BACKR ) EUR SEAT 430x560 WITHOUT CUSHION (BACKR ) EUR SEAT 480x460 WITHOUT CUSHION (BACKR ) EUR SEAT 480x510 WITHOUT CUSHION (BACKR ) EUR SEAT 480x560 WITHOUT CUSHION (BACKR ) EUR - Seat cushion SEAT CUSHION 420x370 TEXTILE (MESH) EUR SEAT CUSHION 450x420 TEXTILE (MESH) EUR SEAT CUSHION 450x500 TEXTILE (MESH) EUR SEAT CUSHION 450x560 TEXTILE (MESH) EUR SEAT CUSHION 500x500 TEXTILE (MESH) EUR SEAT CUSHION 500x560 TEXTILE (MESH) EUR SEAT CUSHION 420x370 VINYL EUR SEAT CUSHION 450x420 VINYL EUR SEAT CUSHION 450x500 VINYL EUR SEAT CUSHION 450x560 VINYL EUR SEAT CUSHION 500x500 VINYL EUR SEAT CUSHION 500x560 VINYL EUR WITHOUT SEAT CUSHION EUR Backrest BACKR. 340x535 EUR BACKR. 340x605 EUR BACKR. 390x535 EUR BACKR. 390x605 EUR BACKR. 440x535 EUR BACKR. 440x605 EUR BACKR. 340 WIDE WITHOUT PLATE EUR BACKR. 390 WIDE WITHOUT PLATE EUR BACKR. 440 WIDE WITHOUT PLATE EUR BACK BIO-MECH. 390x605 EUR BACK BIO-MECH. 440x605 EUR Backrest cushion BACKREST CUSHION 340x535 TEXTILE (MESH) EUR BACKREST CUSHION 340x605 TEXTILE (MESH) EUR BACKREST CUSHION 390x535 TEXTILE (MESH) EUR BACKREST CUSHION 390x605 TEXTILE (MESH) EUR BACKREST CUSHION 440x535 TEXTILE (MESH) EUR BACKREST CUSHION 440x605 TEXTILE (MESH) EUR BACKREST CUSHION 340x535 VINYL EUR BACKREST CUSHION 340x605 VINYL EUR BACKREST CUSHION 390x535 VINYL EUR BACKREST CUSHION 390x605 VINYL EUR BACKREST CUSHION 440x535 VINYL EUR BACKREST CUSHION 440x605 VINYL EUR WITHOUT BACKREST CUSHION EUR Cover backrest (+) COVERS / WITHOUT BACKREST EUR - Adjustment backrest MANUAL ADJUST. BACKREST LOWRIDER EUR MANUAL ADJUSTMENT BACK- REST INCL GAS SUSP 250N EUR Page 3 of 7

4 Adjustment backrest MANUAL ADJUSTMENT BACK- REST INCL GAS SUSP 350N EUR POWERED ADJ. BACKREST EUR 1, Armrest Right ARMREST 250MM,RIGHT TEXTILE (BLACK TRIVERA) EUR ARMREST 250MM,RIGHT VINYL (PU FOAM) EUR ARMREST 300MM,RIGHT TEXTILE (BLACK TRIVERA) EUR ARMREST 300MM,RIGHT VINYL (PU FOAM) EUR ARMREST 350MM,RIGHT TEXTILE (BLACK TRIVERA) EUR ARMREST 350MM,RIGHT VINYL (PU FOAM) EUR ARMREST 400MM,RIGHT TEXTILE (BLACK TRIVERA) EUR ARMREST 400MM,RIGHT VINYL (PU FOAM) EUR WITHOUT ARMREST, RIGHT (BODY AND UPHOLSTERY) EUR Armrest Left ARMREST 250MM,LEFT TEXTILE (BLACK TRIVERA) EUR ARMREST 250MM,LEFT VINYL (PU FOAM) EUR ARMREST 300MM,LEFT TEXTILE (BLACK TRIVERA) EUR ARMREST 300MM,LEFT VINYL (PU FOAM) EUR ARMREST 350MM,LEFT TEXTILE (BLACK TRIVERA) EUR ARMREST 350MM,LEFT VINYL (PU FOAM) EUR ARMREST 400MM,LEFT TEXTILE (BLACK TRIVERA) EUR ARMREST 400MM,LEFT VINYL (PU FOAM) EUR WITHOUT ARMREST, LEFT (BODY AND UPHOLSTERY) EUR Armrest height adjustment ARMRESTS OVER 50MM HEIGHT ADJUSTMENT (STD) EUR ARMRESTS OVER 100MM HEIGHT ADJUSTMENT EUR Armrests reinforcement (+) ARMREST REINFORCEMENT KIT HIGH EUR Armrest mounting ARMRESTS HIGH MOUNTED EUR ARMRESTS LOW MOUNTED EUR - Accessories seat Headrest (+) HEAD SUPPORT "ERGO" TEXTILE (BLACK TRIVERA) EUR HEAD SUPPORT, ADJUSTABLE TEXTILE (BLACK TRIVERA) EUR HEAD SUPPORT, ADJUSTABLE VINYL EUR WITHOUT HEADREST * EUR - Accessories rail headrest (+) ACCESSORIES RAIL HEAD SUPPORT EUR Lateral support (+) LATERAL SUPPORTS SMALL(A) 150x140 TEXTILE (MESH) EUR LATERAL SUPPORTS MED(F) 220x90 TEXTILE (MESH) EUR LATERAL SUPPORTS LARGE(E) 220x150 TEXTILE (MESH) EUR Mounting set lateral support (+) MOUNTING KIT LATERAL SUPPORTS (BACKREST 340MM) EUR - Thigh support (+) THIGH SUPPORTS TEXTILE (MESH) 110x90 SMALL (B) EUR THIGH SUPPORTS TEXTILE (MESH) 165x120 MEDIUM (J) EUR THIGH SUPPORTS TEXTILE (MESH) 200x90 LARGE (C) EUR THIGH SUPPORTS TEXTILE (MESH) 300x90 XLARGE (G) EUR Hip support (+) HIP SUPPORTS SMALL (B) 110x90 TEXTILE (MESH) EUR HIP SUPPORTS MEDIUM (A) 150x140 TEXTILE (MESH) EUR HIP SUPPORTS LARGE (C) 200x90 TEXTILE (MESH) EUR HIP SUPPORTS X LARGE (D) 200x200 TEXTILE (MESH) EUR Seatbelt (+) BELT 2-POINT LARGE NONPAD BODYPOINT INCL BRACK UT EUR BELT 2-POINT LARGE PADDED BODYPOINT INCL BRACK UT EUR Page 4 of 7

5 Seatbelt (+) BELT 2-POINT MEDIUM NONPA D BODYPOINT INCL BRACK UT EUR BELT 2-POINT MEDIUM PADDE D BODYPOINT INCL BRACK UT EUR SAFETY BELT,BUCKLE EUR SAFETY BELT,AUTOTENSION EUR SAFETY BELT,AUTOTENSION LONG VERSION EUR SAFETY BELT,4-POINT EUR Mounting position seatbelt (+) MOUNT POS SEATBELT ROLL RIGHT EUR MOUNT POS SEATBELT ROLL LEFT EUR - Support handles set (+) TRANSFER HANDLES, SET (pair) UNI-TRACK EUR Stump support (+) STUMP SUPPORT SMALL (A) 150x140 TEXTILE (MESH) EUR STUMP SUPPORT MEDIUM (J) 165x120 TEXTILE (MESH) EUR STUMP SUPPORT LARGE (H) 170x175 TEXTILE (MESH) EUR STUMP SUPPORT XLARGE (D) 200x200 TEXTILE (MESH) EUR Mounting position stump support (+) MOUNT POS AMPUTATION SUPP -ORT LEFT EUR MOUNT POS AMPUTATION SUPP -ORT RIGHT EUR - Accessories rail (+) UNITRACK BAR ACCESSORIE -100 EUR UNITRACK BAR ACCESSORIE -50 EUR ACCESSORIES RAIL EUR ACCESSORIES RAIL +50 EUR ACCESSORIES RAIL +100 EUR WHITOUT ACCESSORIES RAIL EUR - Roll bar (+) ROLL BAR LOW EUR Support handle armrest (+) SUPPORT HANDLE ARMREST CORPUS EUR Support armrest inside Right (+) ARMREST SUPPORT,VINYL RIGHT INSIDE EUR Support armrest inside Left (+) ARMREST SUPPORT,VINYL LEFT INSIDE EUR Support armrest outside Right (+) ARMREST SUPPORT,VINYL RIGHT OUTSIDE EUR Support armrest outside Left (+) ARMREST SUPPORT,VINYL LEFT OUTSIDE EUR Incontinence protection (+) INCONTINENCE PROTECTION 430x360/430x410 EUR INCONTINENCE PROTECTION 430x460/430x510/430x560 EUR INCONTINENCE PROTECTION 480x410 EUR INCONTINENCE PROTECTION 480x460/480x510/480x560 EUR Comfort seat cushion (+) SEAT CUSHION COMFORT 450x420,TEXTILE (MESH) EUR SEAT CUSHION COMFORT 450x450,TEXTILE (MESH) EUR SEAT CUSHION COMFORT 450x530,TEXTILE (MESH) EUR SEAT CUSHION COMFORT 450x560,TEXTILE (MESH) EUR SEAT CUSHION COMFORT 500x530,TEXTILE (MESH) EUR SEAT CUSHION COMFORT 500x500,TEXTILE (MESH) EUR SEAT CUSHION COMFORT 500x560,TEXTILE (MESH) EUR SEAT CUSHION COMFORT 450x500,TEXTILE (MESH) EUR Comfort seat plate (+) SEAT PLATE COMFORT 430x460/510 EUR Armrest pouch Right (+) ARMREST POUCH,RIGHT EUR - Armrest pouch Left (+) ARMREST POUCH,LEFT EUR - Page 5 of 7

6 Seat frame pouch (+) SEATFRAME POUCH EUR Bag hooks (+) BAG HOOKS OPEN EUR Back pack (+) BACK PACK INCL. HOOKS EUR Cup/phone holder (+) CUP/PHONE HOLDER EUR Lumbar support (+) LUMBAR SUPPORT,AIR EUR Crutch holder (+) CRUTCH HOLDER EUR Holder oxygen bottle (+) HOLDER OXYGEN BOTTLE CORPUS EUR User control User control NON STANDARD STEERING EUR CONTROL PANEL WITH SMALL JOYSTICK EUR CONTROL PANEL WITH BIG JOYSTICK EUR Joystick holder (+) SIDE STEERING,RIGHT PARALLEL SWING AWAY EUR SIDE STEERING,LEFT PARALLEL SWING AWAY EUR - Tumble switches for switchbox (+) TUMBLE SWITCHES FOR SWITCH BOX SEAT FUNCTIONS EUR Attendant control Attendant control (+) JOYSTICK ATTENDNAT X850 BIG JOYSTICK EUR 1, JOYSTICK ATTENDNAT X850 SMALL JOYSTICK EUR 1, Mounting position attendant control (+) MOUNT POS ATTENDANT CON- TROL LEFT EUR MOUNT POS ATTENDANT CON- TROL RIGHT EUR - Cable attendant control (+) CABLE SET 2 CONTROL PANELS EUR - Supplementary accessories Joystick knobs (+) JOYSTICK KNOB BALL SMALL EUR JOYSTICK KNOB BALL BIG EUR JOYSTICK KNOB CHIN CUP EUR JOYSTICK KNOB MUSHROOM EUR JOYSTICK KNOB SOFT BALL EUR JOYSTICK KNOB STICK EUR JOYSTICK KNOB T-GRIP EUR JOYSTICK SOFTBALL BLACK WITH CONE EUR Chair Order Policy: For other options and special adaptations, please call Permobil for further details. Please also refer to Permobil s Delivery Policy for further information. Your order cannot be processed without the following: - The client s name - The client s measurements - The client s weight Page 6 of 7

7 For your ordering, please sign below with date and company stamp. Signature: Date: Company Stamp: An order confirmations will be provided by Permobil summarizing the items selected. Please review this carefully. Page 7 of 7

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